Active NPI
Thelisha Renee Thomas
- Adult Companion
- Belleview, FL
National Provider Identifier
1336446541
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Companion
- Practice address
- 11802 SE 71St Avenue Rd
Belleview, FL 34420-4672 - Phone
- (870) 714-5246
- NPI assigned
- Feb 24, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Companion | 372600000X | Primary |
Addresses
Primary practice location
11802 SE 71St Avenue Rd
Belleview, FL 34420-4672
Mailing address
PO Box 4975
Ocala, FL 34478-4975
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 693387401 | Medicaid | FL | |
| 693387496 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1298505600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1298505600000",
"number": "1336446541",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 4975",
"city": "OCALA",
"state": "FL",
"postal_code": "344784975"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11802 SE 71ST AVENUE RD",
"city": "BELLEVIEW",
"state": "FL",
"postal_code": "344204672",
"telephone_number": "870-714-5246"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMAS",
"first_name": "THELISHA",
"middle_name": "RENEE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-02-24",
"last_updated": "2011-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "372600000X",
"taxonomy_group": "",
"desc": "Adult Companion",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "693387401",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "693387496",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Belleview, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.